jsb

I would agree with QDRO. For federal purposes, premiums paid by the employee must be post tax. Also, value of premium paid by employer on behalf of same sex spouse must be imputed as income to the employee unless dependency established. Same thing for incoming kids unless other federally recognized process (eg. adoption) occurs to establish legal link between employee the "step" kids. Look to state law for relevant state taxability issues.

One of my favorite variations from who knows where: Valentino, the roseate proboscided wapiti.

Kirk, in our plan (self-administered COBRA) we would look at the intent of the student. If the intent was to enroll, as evidenced by paying fees or similar, we would treat the student as withdrawing from school and everything is prospective. We work to reasonably establish intent. Otherwise, it is treated as a late notification (for COBRA purposes, the onus is on the participant to report loss-of-eligibility events within 60 days), coverage it terminated retroactively, and no COBRA notice or coverage is required.

End of the month, 14K primary lives, governmental plan.

Back to the original post, Banality wrote: "Does this sound like something that benefits managers do intentionally? Do they sit in meetings and discuss how to manipulate the perceptions of the employees through the timing of benefits changes? Furthermore, if this was a deliberate attempt at manipulating mass psychology, was it legal?" Yesterday I sat in a meeting discussing the logistics of managing a payroll error that is going to occur after the first of the year. Part of the discussion was how to inform the employees and their unions, and how the temporary "fix" and ultimate corrections will be handled. Employee perception of these issues was an important part of this discussion, as was the "psychology" of the ultimate correction, which will either be the employee owing the employer some money, or the reverse. It was decided that it that it would be much better from a PR standpoint to have the employer owe the employee at the end so that when the payroll system is ultimately fixed, the employee will receive a "little extra" in their correction check rather than receiving a "short" paycheck. Sometimes benefits managers (as well as other managers) must sit in meetings and discuss the perceptions of employees. "Manipulating mass psychology"? You bet, and absolutely necessary. Ignoring the "psychology" of your work force is a sure recipe for disaster. Will everyone be pleased with our decision? Probably not, but we were honestly working to minimize the impact for the maximum number of people based on a business necessity. Why would a business ignore the reality of the expected reaction of its employees, and fail to take action to minimize bad fallout? Welcome to spin city...

AB 2208 regulates the insurance industry. AB 205 confers spousal-type benefits on registered domestic partners (California Family Code Section 297.5). If benefits are offered to a spouse, they must be offered to a registered domestic partner. A good place to find the text of these bills is at the California Senate Home Page at www.senate.ca.gov. Go to "Legislation" on the left side of the page, and insert the bill number where appropriate on the new page. (sorry, I'm no good with hyperlinks!) Good Luck.

If the coverage is "by virtue of CURRENT employment", then Medicare is secondary. I think you described a situation where the coverage is by virtue of PRIOR employment, that is, retiree status. In this case, Medicare should be primary. We have the same situation. Retirees who return to work on a part-time or limited term basis. They are not eligible for any of our employment benefits. However, they may be covered by one of our group (fully insured) health plans as a result of their status as a pension-drawing retiree. But for their retiree status, they would not be receiving any health insurance from us. If they have it, Medicare is primary.

OK, so I never enroll my family in the health plan, though I could. I would now get your cash payment? I have family coverage and I drop the family, I get the payment? Is a domestic partner eligible for coverage under your plan? If I drop the DP do I get the payment? If I am single, I don't get the payment because I have no dependents? If I'm single and get married, but don't add the new spouse, now I get the payment? If I get the payment and then my spouse and children are all killed in an accident, the payment stops? I have a philosophical problem with this plan, but don't know that it necessarily would violate any laws if structured correctly. Have it reviewed by a VERY GOOD benefits attorney and make sure your organization is willing to take the flak from the single people.

What about the case of an individually covered current QB who got their QB status as, say, the former spouse of an employee? Does that QB lose their status, and therefore their coverage under the plan?

Perhaps my view is not the most compassionate, but then maybe it is. I will not patronize anyone by attempting to rationalize or placate misplaced frustration. I reject the relativistic pabulum so many spew forth in lieu of taking a moral stand on issues. There is a bright line in everyone's belief system which cannot be crossed. Whatever you believe, know yourself and know your line. But society is failing badly when it refuses to enforce a standard for itself. This is little more than polite anarchy. And, frankly, why would anyone be concerned about my, or anyone else's, judgement of them? Have we become so dependent on the validation of others that we are paralyzed without everyone's approval? Sorry, I have neither the time nor inclination to wallow in someone else's limited perception of reality or opportunity. And I feel badly for those good people who are oppressed or put down without cause; I've been there and have the scars. But my sympathy ends when they stay down because it is easier than picking themselves back up. We humans make great victims if we choose that route. Or we can choose to be accountable. I wish I could attribute the following sentiment but I believe it's a compilation of a number of different ideas from different writers. It hangs on my office wall so I will look at it every day. I put it up to help me through a tough time and have seen no reason to take it down. "Thousands of people died last night that would gladly take on ALL of the problems that you think you have in exchange for just 5 more minutes of life today. Don't complain about your problems! If you can change it, get to work on it. If you can't, get over it and move on."

October 5.

Having re-read this string, I am struck by how aptly your list name (banality) describes the tenor of many of your comments. This has become an insipid collection of your self-defeatist, woe-is-me ramblings, which is a real shame for someone who, in stark contrast, seems to be a very bright and articulate person with much to offer. As an employer, I would not consider your looks or medical challenges to be among your flaws. However, until you lose the self-pity which you seem to wear so prominently, it is quite unlikely that you will find much satisfaction or acceptance no matter what you choose to do. Certainly I have no need for an employee with such a disagreeable countenance. One of the most seriously deformed people I have met in my life is also one of the brightest lights shining on this earth. She has an indomitable spirit and exudes grace, compassion, and enthusiasm in whatever she does. Her faith in God and her fellow man are unmatched and her moral compass is straight and uncompromising. Many are put off by her appearance, and they are really quite the poorer for their closemindedness. She would admit there is nothing that she can do about another's attitudes except set an example in her own life. She is surrounded by loved ones and friends, and her sphere of influence continues to grow and positively impact those she encounters. You have been candid in acknowledging some of the shortcomings you feel you have. Work on the ones that don't show up in the mirror. I promise that YOU can't change me or anyone else, but I'll bet that you can do something about you. I think you will find that acceptance from others will quickly follow. "History has demonstrated that the most notable winners usually encountered heartbreaking obstacles before they triumphed. They finally won because they refused to become discouraged by their defeats. Disappointments acted as a challenge. Don't let difficulties discourage you." -- B.C. Forbes

A couple of reasons that come to mind: I have over 13,000 employees with 10,000+ participants. Annual turn-over is around 10%. When the employee quits, they may leave their money in the plan for many years. I don't want to track a beneficiary form in a personnel file (or anywhere else, for that matter) for the next umpteen years. I pay my recordkeeper to keep the records...all of them. The value of that service is diminished by what I must do myself.

GB, I apologize for my misapplication of terminology when I referred to a "pre-tax" contribution by the employer. I really meant a "contribution by the employer that does not have a tax consequence to the employee" thereby being effectively "pre-tax" to the employee. I appreciated your 106 reference. My reference to my payroll system "problems" was just perhaps a little softer than yours. I believe computers should be able to do most anything and are pretty much only limited, as you point out, by the user. (Or as in this case, the programmers, configurers, or others who have set up the parameters of the internal workings of the box. I'm sure ours can be reprogrammed to do post-tax employee deductions, but it is just not high enough on anybody else's priorty list to make it into the "system enhancement" queue.) I was not the original poster and am not questioning whether or to do the late add. Our policies are clear, consistent, well documented, and well communicated. We don't permit late adds.

Since the qualifying event (birth) occurred well in the past, I think you need some other type of event to justify adding the child mid-year. If the "new" father can wait, enroll the child at your next annual enrollment. If he found out he was a father due to some court proceeding by the mother, a copy of the court order should work, even if they have to go back and amend it to cover his obligation for medical support. If this is an amicable discovery, and the father is trying to voluntarily provide the coverage, suggest he establish his parental rights through proper legal channels (amended birth certificate, court orders, ets) and ask for an order from the court that would qualify as a medical support order to permit (or compel) the employer to add the child to the plan.

GB - You state "[t]he payment of premiums on a pre-tax basis for the medical is part of your Cafeteria Plan." Agreed for employee cost of coverage. Do you see tax issues with any (pre-tax) contribution made by the employer? Eg. employer pays $300 toward individual coverage and pays $500 toward family coverage. Adding the child kicks the enrollment level up to family coverage. I think as a matter of plan design you can manage late-adds. By policy, we do not permit late adds except in the rare case of adminsitrative error. Part of the problem is that we are limited by our payroll system in our ability to implement post-tax payroll deductions for benefits. Also, our carriers are not consistent as we have one carrier with "late add" language that specifically states if you miss your 30 day enrollment window, you wait until the employers next annual enrollment period, that is, no late adds ... period. Our other carriers would permit a late add, some with no conditions, others with underwriting. So by policy, we do not permit it.

Sure, why not? Unless excluded by your plan document...

Is the order on the Plan or on the employee? Does the eligibility language for the plan specifically exclude a spouse who is legally separated? If so, I would contend that the court cannot require you to cover someone who is otherwise ineligible. But if not excluded, I'd put the spouse back on. Now there may be a requirement or order on your employee to continue to provide coverage to the separated spouse (or even a divorced spouse - see these all the time), but that is not necessarily your problem. However, you state that this would be a loss of coverage under your plan so COBRA can provide a coverage option, at least for a while. Sandra's suggestion (and Kirk's ditto) to have your attorney review the document is sound.

We don't permit it. Any bank fee would likely be more than your 2%, and then you still have to pay the carrier. Suggest that the person could go and get a cash advance with the credit card. When they complain about the fees and/or service charges, reply "Exactly why we can't take them."

The employer has an absolute right to receive sufficient information, including medical verification, to make a determination about the validity of your FMLA claim. I would agree with mal, the first time may not have been FMLA based on the information you gave us. However, this time is establishing a chronic problem, and it sounds like you have seen the doctor multiple times and can document ongoing medical treatment. The employer (if wise) may even be able to retro assign FMLA to your previous absence based on the new information. I'd approach your HR for help, not confrontation. You're sick, you're worried about your job, you know how hard it is on the company, etc. Do they need you to get any more, or clearer, information from your doctor? (This is one of the major advantages of having a long time personal physician. They are engaged in your good health, whereas the "doc-in-the-box" urgent care mds may be more focused on one or two time treatment, not management of your chronic condition). How can you help them get the information they need to cover their bases? Do they have a doctor that they would recommend or prefer you to see? In HR and claims we see the seediest side of people. It may only be 1% of the people, but it takes 95% of our effort to deal with it. It is refreshing to be able to truly help a fellow employee who is caught in difficult situation, but who is obviously trying to do the right thing without pulling anything over on anyone. If your employment record is otherwise spotless, this should be a breeze. Ask for help and you'll get it. But if you're borderline, understand their skepticism, help them get the info they need, appreciate the challenges they have, and then grow up or move on.

Other than "stocking up" what limits are there on other OTC medications? Wish OTC reimbursement had been available 7 years ago when I started chewing nicotine gum on a 12 week "program". Could have taken some pretty hefty deductions over the 5+ years I chewed it. As noted by Oriecat (and by my doctor as I was chewing) using a patch or gum is better than smoking. I'd reimburse.

Did anything change about the employee's cost? Is the employer contribution identical to before the hours change? If not, you may have an out.

Pretty generous, though from a practical stand point, 10 days is still too short of a time for many for spouse or kids. Our policy allows 5 days for close relatives, which are pretty narrowly defined. Includes the usual - parents, siblings, direct in-laws, grand parents but not grand-parent-in-law, former fosters that you are close to (either parents or kids). Pretty much any relative living in your home will also automatically qualify.

It should be in April or August ("A" months). Since these months have no recognized federal holidays, we could craft one here to give us non-A types a break from the rigors of having to deal with our actuaries. (of course, the actuaries could have the day off too, though mine might appreciate the opportunity to get some work done without being interrupted by numeric mortals.)

Vacation can be negotiable. I think that typically the higher up you are when you start (or if you have unique value that the organization is recruiting or wants to retain), the more negotiable it is. Next time around, negotiate it as part of your hire package. If you have, say, 15 years of industry experience, ask for vacation accruals that recognize that experience.